A coalition of 50 advocacy groups has voiced dismay to the Centers for Medicare and Medicaid Services regarding a proposed reversal of key patient-engagement criteria for Stage 2 meaningful use during the 2015-2017 timeframe.

Stage 2 measures made easier under the proposed CMS rule include: changing the threshold for the Patient Electronic Access measure from 5 percent to “equal to or greater than 1,” and changing Secure Electronic Messaging from a percentage-based measure to a yes-no measure on whether the messaging capability is “functionally fully enabled.”

By no longer requiring that 5 percent of patients view, download or transmit their health information or send a secure message to their providers, the groups say the threshold for patient engagement has become minimal at best as doctors and hospitals would only have to show that one patient used online access to their health information, and that secure messaging was merely turned on—not whether any patient has actually used it.

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“We are deeply disappointed in CMS’s reversal of these essential commitments to patient and family engagement,” the Consumer Partnership for eHealth, the Consumer-Purchaser Alliance, and other organizations wrote in a June 15 letter to the agency. “CMS's proposed amendments constitute a dramatic retreat from essential efforts to make patients and family caregivers true and equal partners in improving health through shared information, understanding and decision-making.”

The groups urged CMS to notto adopt these two proposed amendments “to avoid the substantial harm they would cause for meaningful use and interoperability in 2015-2017, and instead to maintain the existing thresholds for both patient engagement measures.”

What is particularly disconcerting for these groups is that CMS already lowered the bar from 10 percent to 5 percent when it published its Stage 2 final rule. Currently, Stage 2 meaningful use requirements established by CMS not only require that patients have the capability to view, download, and transmit their data, but that 5 percent of patients actually make use of this functionality and send a secure electronic message to their provider. Nonetheless, it remains a struggle for providers to satisfy.

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